Hybrid Epicardial and Endocardial Ablation of Persistent or Permanent Atrial Fibrillation: A New Approach for Difficult Cases

摘要: Background: Although percutaneous epicardial catheter ablation (PECA) has been used for the management of ventricular tachycardia, use PECA atrial fibrillation (AF) not yet reported. Objective: To evaluate efficacy and feasibility a hybrid endocardial AF. Methods: We performed AF in five patients (48.6 ± 8.1 years old, all male, four redo procedures persistent with risk pulmonary vein (PV) stenosis, one de novo permanent [AF]) after an guided by PV potentials 3D mapping (NavX). Utilizing open irrigation tip catheter, left (LA) linear from roof to perimitral isthmus or localized at junction between LA appendage left-sided PVs ligament Marshall (LOM) was performed. Results: successful time <15 minutes. The were eliminated patients. Bidirectional block line achieved two inferior tachycardia conduction observed during area LOM patient. A hemopericardium developed patient, but controlled successfully. During 8.0 6.3 months follow-up, have remained sinus rhythm (four without antiarrhythmic drugs). Conclusion: is feasible effective redo-AF stenosis who are resistant ablation.